Hospice Quality Reporting Program Revisions Proposed    

Situation Report | September 21, 2020

The U.S. Centers for Medicare and Medicaid Services (CMS) plans two revisions to the Hospice Quality Reporting Program (HQRP) measures and the Hospice Item Set (HIS).

These would remove Section O from the HIS and replace the two-part “Hospice Visits When Death is Imminent” measure with a “Hospice Visits in the Last Days of Life” (HVLDL) measure.

Section O of the HIS is where hospices enter the number of visits various staff members made to the patient in the final days of life. This information is used to calculate the paired measure “Hospice Visits When Death is Imminent.”

However, one part of that measure did not meet readiness standards for public reporting (so was excluded from Hospice Compare) while the other component had a negative, or inverse, relationship with one component of the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, so CMS is proposing to replace the entire paired measure altogether.

The proposed new successor measure (HVLDL) is a single measure based on visits by an RN or Medical Social Worker (MSW) in at least two of the last three days of life. The visit data necessary for the HVLDL measure will come directly from hospice claims, thus eliminating the need for Section O of the HIS.

Under this plan, patient discharges occurring after December 31, 2020 will no longer be reported and public reporting under the new claims-based measure would begin on or about February 2021.

CMS is accepting feedback on these changes to the HQRP with comments due by October 13.

See further background here.

HCA hospice members can submit comments here.